Predictors, prevalence and prognostic role of pulmonary hypertension in patients with chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND: To estimate the predictors, prevalence and prognostic role of pulmonary hypertension (PH) in patients with chronic kidney disease (CKD) using meta-analysis. METHODS: The PubMed, EmBase, and the Cochrane library were systematically searched for eligible studies from inception till May 2024. All of pooled analyses were performed using the random-effects model. RESULTS: Fifty observational studies involving 17,558 CKD patients were selected. The prevalence of PH in CKD patients was 38% (95% confidence interval [CI]: 33%-43%), and the prevalence according to CKD status were 31% (95% CI: 20%-42%) for CKD (I-V), 39% (95% CI: 25%-54%) for end stage kidney disease (ESKD) (predialysis), 42% (95% CI: 35%-50%) for ESKD (hemodialysis), and 26% (95% CI: 19%-34%) for renal transplant. We noted the risk factors for PH in CKD included Black individuals (relative risk [RR]: 1.39; 95% CI: 1.18-1.63; p < 0.001), chronic obstructive pulmonary disease (RR: 1.48; 95% CI: 1.21-1.82; p < 0.001), cardiovascular disease history (RR: 1.62; 95% CI: 1.05-2.51; p = 0.030), longer dialysis (RR: 1.70; 95% CI: 1.18-2.46; p = 0.005), diastolic dysfunction (RR: 1.88; 95% CI: 1.38-2.55; p < 0.001), systolic dysfunction (RR: 3.75; 95% CI: 2.88-4.87; p < 0.001), and grade 5 CKD (RR: 5.64; 95% CI: 3.18-9.98; p < 0.001). Moreover, PH in CKD patients is also associated with poor prognosis, including all-cause mortality, major cardiovascular events, and cardiac death. CONCLUSION: This study systematically identified risk factors for PH in CKD patients, and PH were associated with poor prognosis. Therefore, patients with high prevalence of PH should be identified for treatment.

Treatment of malignant airway obstruction with Y-shape sigma stent loaded with I125 seeds installed via rigid bronchoscopy.

PURPOSE: To summarize and analyze the safety and efficacy of a Y-shape Sigma stent loaded with I125 in patients with inoperable malignant main airway obstruction. METHODS: This study was approved by the Institutional Ethics Committee, and a written informed consent was obtained from each participant. A Y-shape Sigma stent loaded with I125 was placed under vision from rigid bronchoscopy. The primary endpoint was alleviation of symptoms and improvement of Karnofsky Performance Status (KPS) score, and the secondary endpoint was complications and technical success. RESULTS: From November 2018 through June 2023, total 33 patients with malignant airway obstruction were palliatively treated by installing Y-shape Sigma stents loaded with I125. The airway lumen was immediately restored and the average airway opening significantly increased to 70 ± 9.4% after the procedure from baseline 30.2 ± 10.5% (p < 0.05). Average KPS score was improved from baseline 30.0 ± 10.0 to 70.0 ± 10.0 (p < 0.05) as well as PaO2 from baseline 50.1 ± 15.4 mmHg to 89.3 ± 8.6 mmHg (p < 0.05). The technical success rate of placing the stent in this study was 73%, and adverse events or complications including bleeding, I125 loss, and airway infection occurred during or after the procedure. CONCLUSION: Placement of Y-shape Sigma stents under vision from rigid bronchoscopy in the patients with malignant airway obstruction is feasible and it immediately alleviates dyspnea and significantly improves quality of life.

Highly Efficient Removal of Lead/Cadmium by Phosphoric Acid-Modified Hydrochar Prepared from Fresh Banana Peels: Adsorption Mechanisms and Environmental Application.

In this work, a phosphoric acid (H3PO4)-modified hydrochar (BPH200) was prepared at a low temperature (200 °C) in an air atmosphere with fresh banana peels as the raw material. The Cd2+ and Pb2+ adsorption behaviors and mechanisms of BPH200 were explored. As the temperature rose, co-hydrothermal carbonization of the banana peels and H3PO4 enhanced the transformation of phosphorus (P) species. More orthophosphate and metaphosphate were found in BPH200 than in banana peel hydrochar (BP) without modification. The adsorption kinetics for Cd2+ and Pb2+ followed the pseudo-second-order model. The Redlich-Peterson model best fit the experimental results of the adsorption isotherm, with maximum adsorption capacities of 84.25 and 237.90 mg·g-1 for Cd2+ and Pb2+, respectively. H3PO4 promoted Cd2+ and Pb2+ adsorption by forming precipitates, which, respectively, accounted for 32.75 and 41.12% of the total adsorption onto BPH200. In addition, the cation-exchange capacities of BPH200 with Cd2+ and Pb2+ were weakened compared with those of BP. However, complexation with these two ions strengthened, accounting for 26.68 and 32.81%, respectively, of the total adsorption capacity. This indicated that the adsorption of Cd2+ and Pb2+ onto BPH200 was dominated by precipitation with minerals and complexation with oxygen-containing functional groups. The removal rates of Cd2+ and Pb2+ by BPH200 from different water bodies were more than 99.95 and 99.97%, respectively. The addition of BPH200 also decreased the amounts of bioavailable Cd2+ and Pb2+ in the soil, resulting in relatively high immobilization rates of Cd2+ (67.13%) and Pb2+ (70.07%).

Combing phosphorus-modified hydrochar and zeolite prepared from coal gangue for highly effective immobilization of heavy metals in coal-mining contaminated soil.

Considering the adverse effects of heavy metals (HMs) on agriculture soil, in-situ immobilization has been paid great attention worldwide. P-modified biochar/hydrochar along with synthetic zeolite for efficient HMs immobilization in contaminated soil becomes a promising choice. In this study, H3PO4-modified hydrochar (BPH) derived from banana peels, and Na-X zeolite (ZL) prepared from coal gangue was applied individually and synergistically (1%BPH, 2%BPH 1%ZL, 2%ZL, and 1%BPH+1%ZL) to remediate a farmland soil polluted by Cd, Cu, and Pb near the coal-mining area. Compared with the mono-application of these two amendments, their combination significantly improved the soil organic carbon (SOC), electric conductivity (EC), and dehydrogenase activity. Besides, the addition of 1%CLH+1%ZL remarkably reduced the Cd, Cu, and Pb bioavailability by 67.01%, 57.01%, and 78.72%, respectively, in the soil after 100 d incubation by transforming these metals to more stable forms. The order of the HMs immobilization capacity for these two amendments was as follows: Pb > Cu > Cd. Moreover, the dominated immobilization mechanism of their synergistic application was that BPH could immobilize HMs by precipitation, complexation, and π-π electron-donor-acceptor interaction. The precipitation and complexation blocked the surface pores of BPH. The sustained release of phosphorus groups and radicals was prevented. This obstacle was possibly alleviated by adding ZL. Besides, the formation of cationic bridging, the enhancement of soil properties, and the physical adsorption of these amendments were also conducive to HMs immobilization in soil. This work indicated that co-application of BPH and ZL possibly was an excellent choice for immobilizing HMs in soil.

Facile Synthesis of Cauliflower Leaves Biochar at Low Temperature in the Air Atmosphere for Cu(II) and Pb(II) Removal from Water.

In this study, a facile and low-cost method for biochar (CLB) preparation from vegetable waste (cauliflower leaves) was developed at a low temperature (120 °C) in the air atmosphere. The prepared mechanism, adsorption mechanism, and performance of CLB for Cu(II) and Pb(II) sorption were investigated using Scanning electron microscopy- energy dispersive X-ray spectroscopy(SEM-EDS), X-ray diffraction(XRD), Fourier transform infrared spectroscopy(FTIR), and a series of sorption experiments. Then the CLB was subjected to single and double element sorption studies to examine the effect of pH value on the Cu(II)/Pb(II) sorption capacities and then competitive sorption priority. There are both more hydroxyl (-OH) and carboxyl (-COOH) functional groups on the surface of CLB compared to those from control (without H3PO4 impregnation), resulting in more ion exchanges and complexation reaction for CLB with Cu(II) and Pb(II). Besides, the phosphorus-containing groups (e.g., P = OOH, P = O.), which newly formed with H3PO4 impregnation, could also enhance sorption, especially for Pb(II), this way leaded to its adsorption and precipitation as Pb5(PO4)3OH crystals. The performance of maximum adsorption capacities of CLB toward Cu(II) and Pb(II) were 81.43 and 224.60 mg/g, respectively. This sorption was slightly pH-dependent, except that the sorption capacity improved significantly as the pH value of the solution increased from 2 to 4. Competitive sorption experiment confirmed that Pb(II) had a higher sorption priority than Cu(II).

Highly effective removal of Pb2+ in aqueous solution by Na-X zeolite derived from coal gangue.

The present study aimed to synthesize Na-X zeolite from coal gangue powder (CGP) via the alkali fusion hydrothermal method. The optimal synthetic conditions were investigated, the mass ratio of CGP/NaOH(s) was 1:1.25, and crystallization reaction time was 12 h. X-ray powder diffraction, scanning electron microscopy energy-dispersive X-ray spectrum, and Fourier transform infrared spectrometer techniques were used to test the properties of resultant zeolite product, which was highly identical to that of commercial zeolite. The efficiencies of the synthetic zeolite for Pb2+ adsorption were analyzed on factors including solution pH, adsorbent dosage, temperature, and contact time. Compared with the pseudo-first-order, Elovich, Freundlich, and Temkin models, the pseudo-second-order and Langmuir models were fitted more satisfactorily with the dynamic data and adsorption equilibrium data, respectively. The maximum Pb2+ adsorption capacity of synthetic zeolite (457 mg/g) could be reached when the pH, contact time, temperature, and initial Pb2+ concentration was 6, 40 min, 45 °C, and 200 mg/L. The adsorption capacity was higher than many of the natural and synthetic zeolites reported in previous literature.

Application of integrated ozone biological aerated filters and membrane filtration in water reuse of textile effluents.

A combined process including integrated ozone-BAFs (ozone biological aerated filters) and membrane filtration was first applied for recycling textile effluents in a cotton textile mill with capacity of 5000 m(3)/d. Influent COD (chemical oxygen demand) in the range of 82-120 mg/L, BOD5 (5-day biochemical oxygen demand) of 12.6-23.1 mg/L, suspended solids (SSs) of 38-52 mg/L and color of 32-64° were observed during operation. Outflows with COD≤45 mg/L, BOD5≤7.6 mg/L, SS≤15 mg/L, color≤8° were obtained after being decontaminated by ozone-BAF with ozone dosage of 20-25 mg/L. Besides, the average removal rates of PVA (polyvinyl alcohol) and UV254 were 100% and 73.4% respectively. Permeate water produced by RO (reverse osmosis) could be reused in dyeing and finishing processes, while the RO concentrates could be discharged directly under local regulations with COD≤100 mg/L, BOD5≤21 mg/L, SS≤52 mg/L, color≤32°. Results showed that the combined process could guarantee water reuse with high quality, and solve the problem of RO concentrate disposal.